Pushing the Integrated Employment Agenda: Case Study Research in Washington State

Case Studies 15

This is the second in a series of publications highlighting findings from case studies in three states-- New Hampshire, Washington, and Colorado-- that are recognized as high performers in integrated employment. These products are intended to be a practical resource for states as they work to help people with disabilities obtain and maintain gainful employment.

ICI identified "high-performing" states based on the following criteria: the percentage of citizens served by the state's mental retardation/developmental disabilities agency that participate in integrated employment, and the rate of growth in integrated employment.

In 2003, a team of ICI researchers conducted face-to-face interviews with state and local key informants, including parents and service providers, who were knowledgeable about the Washington integrated employment system. With permission, interviews were tape-recorded and transcribed. State policy documents and the state website contributed to the research.

History

Washington stakeholders report that the state's focus on employment started in the late 1970s with values-based training based on the Program Analysis of Social Services (PASS-3) model. These workshops were widely attended over several years, and many of today's key players in state and county services participated as leaders. One of the outcomes of this period was the first edition of the County Guidelines, a document that guided county and service providers' contracts. The emphasis on employment established in the guidelines was nurtured by a system of management that had a clear focus on employment at the county level.

In 1985, Washington was awarded a Rehabilitation Services Administration Systems Change Grant. The state used this funding to develop a systemic approach to provide integrated employment, restructuring its state MR/DD agency to that end. Between 1985 and 1990, the state established and met the goal of having 1000 people participate in integrated employment (Washington Initiative for Supported Employment, n.d.).

Washington also served as an early laboratory for integrated employment opportunities. Data suggests that leaders sought out and embraced ideas from other areas and regions of the country to provide the most integrated services possible. Two early projects in the Pacific Northwest were particularly noteworthy. The University of Washington food service program provided evidence that individuals with mild disabilities could successfully be employed in the community. And work at the University of Oregon demonstrated that individuals with more significant disabilities could learn increasingly complex tasks.

Strong linkages between researchers and the community service system provided a platform for questioning the status quo and developing alternative models for employment support, helping set the stage for Washington to become a national leader in the integrated employment movement.

Findings

Our research suggested five themes that led to success of integrated employment in Washington:

Coherent Values Base

Clear Focus on Employment Outcomes at the County Level

Flexible, Outcomes-Oriented Funding

Consistent Investment in Training and Technical Assistance

A Strong Network of Leaders

This section discusses strategies Washington used to further the goal of employment and strengthen the emphasis on integrated employment as the preferred service outcome for individuals with MR/DD.

Theme One: Coherent Values Base

Mostly I believe that the only safeguard for people with developmental disabilities is how people think about them... If we don't have impact on values, you put people at risk.

In the 1980s the spread of a values-based service philosophy across the state had a significant impact on the number of stakeholders who believed in the importance of increasing opportunities for community inclusion. An additional key factor that impacted the development of the Washington Division of Developmental Disabilities (DDD) system's values was the widespread belief that everyone could work and contribute to their communities. The intersection of the value of work and community inclusion set the standard that integrated employment was the expected service outcome for people with MR/DD. Respondents noted that the "state culture supports the idea of being individually productive," saying that "the argument becomes about where a person works and not if he works." Respondents believed that nearly everyone was "ready to work," which allowed the system to focus on individualizing employment experiences. Many respondents felt that all work was highly valued in the state, and indicated that sheltered work was preferred over community-based non-work activities.

The County Guidelines

DDD administration sought to formally institute the values of community inclusion and work through the County Guidelines. The first edition was developed by a group of stakeholders entitled Committee No. 1. Most of this group's members had completed values-based training, and designed the guidelines under the belief that inclusive employment was a civil right. The creation of the County Guidelines was described as an educational experience for the entire system that helped state leaders create a common vision for DDD services in Washington. Committee members reflected:

Committee No. 1 began to look at outcomes instead of [service] inputs. Up until that point, we were looking at inputs such as... "What is the temperature of the water.... Committee No. 1 began to think about "What do we really want for people?" If we believe what PASS is telling us, we need to look at outcomes for people that clearly identify [that] if we want work for people, then the only way you're going to get it is having people work.

At the time of the research, the County Guidelines continued to provide a framework for how counties contracted with employment service providers. The guidelines functioned as a policy framework and not a contractual obligation, allowing for a clear focus on integrated employment as the preferred employment outcome. One provider explained, "The County Guidelines are used to set policy and direction-- there were not a lot of other mandates [from the state]." One provider commented on the success of the County Guidelines in guiding service expectations, namely "how they run it and what they expect of you.... If the expectations weren't there, a lot of programs that are doing as well as they are doing, wouldn't be."

The County Guidelines were also praised for their flexibility. While the guidelines set the expectation that counties would engage in community development activities, they did not prescribe what types of activities the counties should undertake. Counties were given the flexibility to target stakeholders for community development activities, including schools and private industry, based upon local service needs.

Collecting data on employment outcomes helped to keep the state focused on fulfilling the expectations of the County Guidelines. Since the early 1980s, the state has collected and tracked wage and hour information for individuals on a monthly basis. Early on in the development of the state's integrated employment system, DDD developed measurable monthly goals to increase the quantity and quality of employment placements. Data were collected on individual employment outcomes and used to assess whether monthly goals were met at the regional, county, and vendor levels.

Theme Two: Clear Focus on Employment Outcomes at the County Level

The Division of State and County Roles

The County Guidelines held state DDD staff responsible for residential services and case management while county staff members were responsible for employment and day supports. One respondent noted, "We decided early on that model coherence called for separation between home and work," suggesting that establishing the narrow focus of the state and county administration was intentional.

The division of state and county roles helped enhance the quantity and quality of Washington's integrated employment outcomes. County coordinators' responsibilities were concentrated in their communities, allowing them to develop an extensive knowledge of the local issues and employment field. This gave coordinators the opportunity to customize county programs to match state goals for employing people with disabilities.

Respondents noted that the separation of powers protected the counties' integrated employment programs during state fiscal crises and times when state DDD administrators had to focus on non-employment-related issues. One state administrator noted that this relationship also protected county coordinators from local criticism. County coordinators had the freedom to say, "The state made me do it," backed by the state's support with messages such as "They're doing what we told them had to be done."

Furthermore, the state/county dichotomy allowed controversial decisions to be made across the state at the local level. By limiting the visibility of potentially volatile decisions to the county level, such as the elimination of sheltered workshop funding, the system could push policies locally that may have been met with large-scale opposition at a statewide level.

Local Control That Supports Innovation

Inevitably, local control produced differences between counties. One provider who supported people in three counties described having to work within the practices and cultures of three different systems. Variation occurred on multiple levels. For instance, respondents reported that some counties pushed self-directed funding, while others viewed it as a distraction to service delivery. Clark County had ended funding for sheltered workshops while other counties in the state were reluctant to eliminate sheltered workshops and yet others had stopped providing funding for group integrated employment.

One reason for differences across counties was the location of specific leaders. Members of the integrated employment community who held state/national leadership roles could provide and direct resources and skills to their counties, allowing these counties more opportunities to innovate. For example, King County coordinators mandated that individuals in large sheltered workshops move out of segregated programs.

Local variation also developed because of support for innovation in employment. Pilot programs were funded in some counties to meet specific local needs but also to increase the knowledge base of all employment providers. Pilot programs were an opportunity to try new and creative ideas, and because of their inherently preliminary nature, were given the space to evolve before their outcomes were evaluated. When pilots eventually received positive evaluations, these initiatives were introduced in other counties. The level of innovation diffusion in Washington was noteworthy. Traditionally, innovation spread from urban counties to more rural areas.

Another source of local differences was county property tax revenue. Washington law designated that 2.5 cents per thousand dollars of property tax revenue be used to support mental health and developmental disability services. While this discretionary revenue comprised only a small part of overall county-level DDD funds, it allowed county DDD agencies to strategically leverage other dollars for pilot projects and training/technical assistance. These local funds were also instrumental in allowing counties to supplement decreases in integrated employment funds due to changes in state budget priorities.

Theme Three: Flexible, Outcomes-Oriented Funding

Funding for integrated employment in Washington was allocated largely through the DDD administration. Each county had the freedom to design its funding structure to meet local goals. Counties in Washington used a variety of different funding mechanisms, including fee-for-service, self-directed individualized budgets, and block contracts.

The diversity of approaches for funding produced significant integrated employment outcomes in Washington, and is an important finding. The County Guidelines were designed to give providers clear expectations for employment services and outcomes. Counties developed their funding structures within the context of the localized needs of individuals with disabilities, providers, and businesses. This localization helped to ensure the development of funding structures that supported the goals of the County Guidelines and the needs of the community.

A significant number of respondents to this case study worked in counties that paid employment providers via block contracts. These counties were noted for having providers that were especially dedicated to expanding integrated employment opportunities. Over time, counties that used block funding noted that the funding method evolved into a business model that produced quality employment results.

One perceived benefit of block contract funding was that it supplied providers with a consistent source of income to pay for marketing employees with MR/DD to the business community, while eliminating the financial pressure to document billable hours. It was also noted by providers who were paid through block contracts that they had the flexibility to evaluate their resource allocation with individuals' changing needs in mind. Respondents felt that this adaptability permitted agencies to support a variety of people in integrated employment, including those with more significant needs.

Simultaneously, other counties emphasized the development of self-directed funding models through individual budgeting. The goal of this funding mechanism was to increase the autonomy of individuals with MR/DD to pursue their employment goals by giving them the opportunity to choose among several local employment providers. For this reason, many counties moved towards self-directed funding models.

Interagency Funding

At times, DDD funded integrated employment in conjunction with other state agencies. Monies from the 1985 Systems Change Grant were important for stimulating shared funding across agencies. This grant had the long term impact of encouraging collaboration between different state agencies and was partly responsible for encouraging the state legislature to support regulation allowing DDD, the Division of Vocational Rehabilitation (DVR), and the Division of Mental Health (DMH) to share funding. In 1994, the legislature passed a provision that required DDD, DVR, and DMH to share funding around joint customers. One state administrator commented, "It sort of forced them into a referral relationship that we didn't previously have. And that proviso was in place for many years." Although this program had formally ended, it demonstrated the advantage of having flexibility in funding to meet individuals' multiple needs.

Strategic Funding as a Tool for Change

Washington has been willing to use funding to influence programmatic change. Values-based training and the County Guidelines led to an understanding across the state that the desired outcome was employment, and thus the state must support integrated employment services more intensively than other day services. Counties stressed the importance of work by limiting funding for traditional facility-based, non-work day programs such as day habilitation. At the time of these interviews, fewer than 40 individuals statewide received Adult Day Health services.

Respondents noted that Washington used funding to sustain employment growth during challenging times. When the DDD system experienced fiscal deficits in 1992, some counties decided to reduce funding for sheltered employment to ensure that integrated employment programs received adequate funds. The desire to ensure not only the maintenance but the growth of integrated employment, despite state budget deficits, at times led to reductions in funds for other day services. When King County experienced a 16% reduction in funds for employment services, rather than decreasing each agency's budget by 16%, a decision was made to cut all budgets by 20% and reallocate the extra 4% to fund integrated employment programs.

Many counties across the state eliminated funding for sheltered workshops, while other counties adjusted their own rates of employment funding so that integrated employment was funded at a higher rate than sheltered employment. King County developed an early moratorium on sheltered workshops, and Clark County eliminated any new county funding for sheltered employment. Other counties reported formal goals to reduce or eliminate sheltered employment within their service areas.

Looking Ahead

Although respondents reported that the long-term maintenance of funding for integrated employment was one of the reasons for the state's successful outcomes, they were concerned that adequate funds to support the system were in sharp decline. Growth in the state population along with limited growth in overall DDD funding resulted in an increase in the waiting list for integrated employment services, and some feared a decreased emphasis on quality outcomes. In 2001 respondents reported that a legislative proposal was in process to end all state funding of sheltered workshops. However the legislation provided no additional money to provide integrated employment services for these displaced workers. The overall financial instability created debates in the MR/DD community regarding the importance of preserving DDD funding versus eliminating sheltered work programs.

There was evidence of long-term financial support for training and technical assistance (TA) in Washington. Ongoing training and TA were instrumental in disseminating innovative values and employment practices across the state. As a whole, Washington's training and TA activities provided ongoing opportunities for networking, debate, and innovation-sharing, targeting service providers, individuals, and county and state administrators.

Early in the development of Washington's integrated employment services, values-based training was offered to individuals with disabilities, their families, and employment providers, with the goal of increasing expectations. One former county coordinator noted that all of her employees had been required to attend values-based training, from administrative staff to county board members. "We wanted people singing off the same sheet of music. And you needed to go through PASS-3 training in order to have that real solid basis."

Since that time, with DDD support, counties have targeted parents for training on service expectations, including employment. This training was provided through county-based Parent Coalitions that helped parents articulate their service expectations. Several counties had active Parent Councils that sponsored fairs to educate parents about funding, finding a vendor, and what their expectations should be for work. Family education also occurred on a parent-to-parent basis and by inviting families and self-advocates to conferences.

Ellensburg: A Consistent Forum for Change

The nationally recognized Ellensburg Employment Conference is an example of Washington's commitment to training. Since 1977 Ellensburg has provided opportunities for all levels of staff, including frontline day and employment staff and state and county administrators, to learn about innovations in the field. Ellensburg has also been an opportunity for the state to showcase successes. Currently coordinated by the Washington Initiative for Supported Employment (WISE), the conference has been supported over the years by a number of entities including counties, DDD, and the Developmental Disabilities Council.

From its inception Ellensburg served as a catalyst for providers to develop new ways of thinking about employment supports for people with MR/DD. The conference was originally designed for frontline staff, with the intention that they would spread innovations in integrated employment to their agencies. One respondent described the conference as "the beginning of a challenge." Topics addressed at Ellensburg have been chosen to promote best practices and innovation in integrated employment. Respondents shared that at times a "hard line" was taken to influence change. The conference has been perceived at times as controversial and even rebellious due to organizers' willingness to confront perceptions about employment.

DDD administration and several counties have also funded annual issues forums described as "mini-Ellensburgs." The goal was to provide an opportunity for stakeholders in the field to meet, identify key issues affecting employment in the state, and develop solutions. One respondent described the context of the meetings: "They bring all the movers, shakers, and thinkers from residential, family, individuals, VR, counties, mental health, and schools. We go and just anguish over the issues."

Shaping Training and Technical Assistance

Several groups have been active in providing training and TA in Washington. The relative concentration of training and TA funds allowed Washington central coordination of employment forums, as well as the opportunity to import nationally known trainers to the state. At the time of the interviews, a wide variety of external consultants were actively involved with Washington. Trainers routinely addressed the topics of community inclusion, job development, relationships, working with people with challenging behaviors, and general employment issues. Some county coordinators and other DDD staff maintained ongoing contact with these national experts and had used these trainers as informal mentors.

The Initiative was funded in 1985 under the Rehabilitation Services Administration's Systems Change grant to "help shift state policy and investment away from maintenance, segregation, and isolation, and toward employment and the inclusion of people with significant disabilities" (Washington Initiative for Integrated Employment, n.d.). The Initiative was designed to develop a public/private integrated employment infrastructure with the intent that as integrated employment became a reality, the group's work would no longer be necessary. However, at the end of the systems change grant in 1990 the community came together and supported a line item in the state budget to support the project's continuation, and the Initiative became a private, nonprofit organization: the Washington Initiative for Supported Employment (WISE). This group received funding from the counties and the state to provide training and individualized TA.

O'Neill and Associates was an additional training resource funded by state and county DDD that has consistently been awarded funds to conduct and broker integrated employment and related values-based training. This group had been a state training contractor for over twenty years. Initially its contract focused on systems change and moving adult activity programs to community-based outcomes, but over time the emphasis shifted to integrated employment. Training requests came from both county coordinators and employment providers. While the organization did not provide direct services to people with MR/DD, they often supported and assisted providers to develop an infrastructure of support for an individual and at the time of the interviews had a staff member sited at a One-Stop Career Center to focus on the employment of individuals with MR/DD. The consistent awarding of a state training contract to O'Neill and Associates at times raised controversy. One respondent said:

They [the state] put this reasonably small amount of technical assistance money in the hands of one group [O'Neill and Associates] that was savage about people being employed. There is still controversy about putting those dollars in one area and not putting some into sheltered employment.

Challenges to Training and TA

Money for training and TA in Washington was substantial during the Systems Change grant. However, even though the state budget experienced a decline in revenue and the DDD budget faced a reduction in funding in the early 1990s, respondents noted that there was a concentrated effort to protect funding for training and TA. This often occurred in "closed-door" meetings at both the state and county levels.

One additional challenge faced by the state was engaging young professionals in training and development. Concerns about the values, attitudes, and context of newer staff troubled some respondents. One individual stressed the importance of teaching newer staff, especially case managers, the values behind Washington's successful employment outcomes. At the time of these interviews there was discussion around reinstituting PASS trainings for newer staff to increase their commitment to quality employment outcomes.

Theme Five: A Strong Network of Leaders

Leadership, relationships, and advocacy worked together to produce high rates of integrated employment in the state. The long-term relationships that existed between the state's integrated employment leaders and an interrelated and sustained advocacy community provided another forum for Washington to maintain its focus on the growth of integrated employment for people with MR/DD.

Leadership

A state administrator commented that the state's success could be attributed largely to the values embedded in the system and, in particular, to the individuals who had been with the system for many years and experienced the early values clarification process. A longstanding network of stakeholders in state and county government, provider agencies, and the advocacy community developed as a result of the values-based training and County Guidelines. Longtime leaders expressed nostalgia for these formative experiences. One person described the introduction of integrated employment as "a magical kind of time. It was new and different, and we had a charge and a mission." Members of this stakeholder group expressed bonding around the idea that "we're in this together."

The county coordinators were a prominent piece of this larger leadership network. County coordinators were connected through their early work in the movement for integrated employment. One provider described them as "the war horses" of the movement. One informant attributed the manageability of the coordinators' job (compared to other MR/DD administrators nationally) to the longevity of the group's intense commitment to employment. The state/county structure provided a financial and administrative buffer for challenges to integrated employment. This freed the coordinators to concentrate on their work with individuals, providers, families, and businesses. One former coordinator commented, "We were able to do whatever it took to get people employed."

Several integrated employment providers were considered part of the network of longstanding leaders. Like the county coordinators, providers who consistently produced quality integrated employment outcomes were noted for having stability in the composition of management and frontline staff. This group of providers is noted for consistently challenging themselves to improve services.

Recently, challenges to the longstanding leadership in integrated employment had developed. The core group of employment advocates was beginning to retire, leaving a gap in leadership, and respondents expressed concern about an emerging generation of leaders in the field. "It's a whole different experience for the new professionals," one said. They felt that the new generation of leaders had not experienced the same process of values exploration as the earlier generation. Lacking these truly formative experiences, new leaders might lack the intense commitment and strong relationships that had helped dramatically improve access to integrated employment.

Relationships

The endurance of both the county coordinators and the providers, as well as the development of mutually supportive relationships between the two, was one reason for the continued advancement of the system. Respondents noted that the early growth in integrated employment relied on trust within the system. The state trusted the providers to produce good outcomes and allowed them freedom to explore nontraditional ideas. One provider elaborated:

The system, the way it worked, was a system of trust. They not only trained us, but they trusted us to be able to use the dollars in the most effective way. And in the end we produced pretty good outcomes.

This relationship grew over time so that providers who consistently produced quality outcomes were given more latitude to be creative in their employment supports.

Leaders reflected on the importance of connections, not only within their own group but with various state and county agencies. They used these relationships to deepen their understanding of agencies' regulations and culture. These connections allowed stakeholders to identify allies in these groups who would later be in the position to champion integrated employment initiatives from outside DDD. These relationships were political: stakeholders emphasized the importance of connecting themselves to issues that were important to their allies, even if these issues were not directly related to employment. This backing enabled stakeholders to garner support for integrated employment (specifically the maintenance of funding for TA) during fiscal crisis.

Advocacy

Coordinators, providers, and other stakeholders worked successfully through formal and informal alliances to effect political change throughout the state. Said one respondent, "All of our business is like relationships-- with the families, the individuals, employers, legislators."

Stakeholders used political advocacy to educate elected officials about the importance of employment for people with MR/DD. Providers, county administrators, families, and other advocates reached out to their elected state representatives to keep integrated employment a priority. Other advocacy work was conducted through various county and parent coalitions. The parent coalitions in particular were effective in maintaining legislative support for integrated employment.

Working together, county administrators and parent coalitions developed legislative forums on integrated employment. Many legislators and administrators attended the forums regularly because the coalitions used the gatherings to praise and recognize those who worked to increase employment opportunities for individuals with MR/DD. Through these gatherings, many legislators were educated about the long-term benefits of integrated employment.

It is important to note that integrated employment is perceived as a bipartisan issue among state legislators in Washington: "It's not a Republican issue, not a Democrat issue. It's a work issue. Convince them that you're paying less taxes and people are being productive." The majority of this work was done through "simple, common, networking stuff. Networking is what pays off."

One network was particularly noted for its effectiveness: P2020, a loosely knit provider advocacy group made up primarily of agencies offering integrated employment services. Respondents highlighted the group's consistent work to continually push the integrated employment agenda at the state legislative level. P2020 member agencies paid an annual fee to fund a part-time state lobbyist, and actively monitored any legislation that affected employment in the state. It was reported that this group was instrumental in defeating two legislative bills that would have severely impacted the ability of the system to continue producing quality integrated employment outcomes. The group was also recognized for drafting legislation to introduce integrated employees into state government (see text box below).

Integrated Employment in the Public Sector

King County's program to employ people with disabilities in county jobs was one example of how the three key factors -- leadership, relationships, and advocacy -- worked together to increase opportunities for integrated employment. It is also an example of the level of information diffusion across the state. At the time of the research, similar initiatives were active in other counties and within state government positions.

Inspired by a Larry Rhodes article that noted that over 10% of non-agriculture jobs were in the public sector, in 1989 O'Neill and Associates submitted a grant application to the Rehabilitation Services Administration to develop public sector jobs for people with significant disabilities. These jobs were to be concentrated in King County government because of the availability of high-paying jobs with benefits. With the political assistance of a King County Councilor, the County approved a resolution to encourage county departments to hire people with developmental disabilities in 1990 (Mank, O'Neill, & Jenson, 1998).

Recognizing that it would be difficult for the King County employment program to achieve quality outcomes with only short-term intervention, a permanent county-level employee was hired to serve as a full-time job developer for the program. This job developer was focused solely on working with department managers to develop their interest in integrated employment and identify potential departmental jobs. The staff person also trained county employees to support co-workers with disabilities. The job developer did not specify the job tasks to be completed or provide long-term support to employees with disabilities. Instead, integrated employment providers were contracted to conduct detailed job analysis and identify appropriate job matches. One important feature of this division of responsibility was that it freed the county-level job developer to expand relationships with county departments without the responsibility of having to develop the long-term supports. This was also true for the integrated employment providers engaged in the program: They could focus on supporting the employee with a disability and not maintaining a relationship with the county department heads.

By January 2006, King County employed over 60 people with disabilities who earned average wages of $20,000 per year and received full health and retirement benefits. The initiative had expanded across the state to include approximately 45 integrated employees with the City of Seattle, over 100 people with developmental disabilities in state government, and the replication of the King County program in other counties across the state.

The state of Washington passed legislation to promote the employment of people with severe disabilities in state government. This legislation enabled departments to hire employees with disabilities despite not having an official position vacancy or the ability to create a new position. Lobbying by P2020 ensured that integrated employees did not count against the state's full-time employee allotment.

Recognition as an Advocacy Tool

An additional advocacy tool was the development of the state's reputation for supporting excellence in employment for people with MR/DD. Stakeholders who received recognition as leaders in the field said that they were proud of the honor. Stakeholders also took pride in the fact that people traveled from across the country and from other countries to learn from Washington's employment experiences. The Ellensburg conference was an especially important activity that increased state pride. It was described as an event that "showcased state activity" and was "nationally renowned." Key legislators received recognition at this conference. This public support was another factor that helped maintain legislative support for integrated employment.

Successful providers were included in the state and national acknowledgment of Washington's accomplishments. State leaders sought to ensure that providers who developed creative employment situations were recognized as well. This publicity created a climate of collegial competition between providers that increased the desire to produce successful integrated employment outcomes, spurring the investment of limited resources into creative employment techniques. Recognition of providers also occurred via supporting staff members to travel to advanced integrated employment trainings.

Finally, the integrated employment system in Washington was committed to using recognition of private industry as an advocacy tool to increase integrated employment. County and provider staff worked to ensure that businesses that were receptive to employing people with MR/DD were recognized through state-level awards. Businesses in turn used this recognition as a public relations tool to increase their number of patrons and act as role models for other businesses who were interested in supporting employees with MR/DD.

Conclusion

Washington's twenty-year commitment to the growth of integrated employment services was a direct result of the DDD's focus on the goal of integrated employment. This clear vision stemmed from the values developed by leaders through values-based training. The system then stayed on track by concentrating resources into integrated employment services over sheltered employment services, investing in training and TA to providers, and designing the County Guidelines. Ongoing strategy and policy innovations included the county and state government public sector employment initiative, the elimination of funding for sheltered employment, and the gradual shift to consumer-directed funding. While the current administrative, financial, and leadership stressors on the system placed many stakeholders in a defensive position to protect the state's progress, they hoped that the twenty-year legacy of quality integrated employment in Washington would instruct future generations working to push the employment agenda.

Sustaining Integrated Employment

Washington's Division of Developmental Disabilities (DDD) used the following strategies to maintain a clear, consistent focus on integrated employment as the preferred service outcome.

Funding training and TA to spread the system's values to all state and county DDD staff, providers, individuals with MR/DD, families, lawmakers, and businesses.

Making the consistent statement that individual integrated employment was the priority outcome, and collecting and evaluating monthly employment outcome data to assess progress in reaching that goal.

Developing flexible funding structures at the county level to support integrated employment placements.

Funding pilot programs to pioneer new employment practices that met the needs of local communities.

Funding training and TA to spread innovative employment practices.

Supporting opportunities for networking between state and county DDD staff, providers, individuals with MR/DD, families, lawmakers, and businesses.

References

Mank, D., O'Neill, C. T., & Jenson, R. (1998). Quality in supported employment: A new demonstration of the capabilities of people with severe disabilities. Journal of Vocational Rehabilitation 11, 83-95.

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